Director of Case management permanent position at Lakewood CA

Director of Case management permanent position at Lakewood CAFull-timeTitle: Director of Case managementLocation: Lakewood, CAType: PermanentThe individual in this position has overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput and ensure compliance with all state and federal regulations related to case management services.Scope of ServicesUtilization Management supporting medical necessity and denial preventionTransition Management promoting appropriate length of stay, readmission prevention and patient satisfactionCare Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of careCompliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policyEducation provided to physicians, patients, families and caregiversJob responsibilitiesManage department operations to assure effective throughput and reimbursement for services providedLead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvementEnsure medical necessity review processes are completed accurately and in compliance with CMS regulations and Tenet policyEnsure timely and effective patient transition and planning to support efficient patient throughputImplement and monitor processes to prevent payer disputesDevelop and provide physician education and feedback on hospital utilizationEnsure compliance with state and federal regulations and TJC accreditation standardsOther duties as assignedRequired Qualifications5 years acute care experienceTwo years acute hospital case management leadershipDemonstrated organizational skillsExcellent verbal and written communication skillsAbility to lead and coordinate activities of a diverse group of people in a fast paced environmentCritical thinking and problem solving skillsJ-18808-Ljbffr